One of the most challenging situations for parents is how to address death, grief and loss with children and teens. What can we say? How can we help? What can we do? Children, just like adults, express their grief in a variety of ways. Some may cry openly and express their deep sadness or confusion, some may experience fear or anger, or may suddenly experience physical symptoms such as stomach aches, headaches, sleeplessness or a lack of appetite. They may express worry or anxiety about school work, sports or activities that they normally enjoy.
Loss is more intense when the person who has died was close to the child - especially a parent or sibling. Grief will come and go and may or may not be expressed verbally. It will often become more intense during significant life events, holidays or anniversary dates of the loss.
Understanding how that child or teen understands or views death can be helpful in supporting them at any age. Their understanding will change as the child develops socially, emotionally and intellectually. The guide below From cancer.net can shed light on a child's perspective based on age:
Infants (birth to 2 years)
Have no understanding of death.
Are aware of separation and will grieve the absence of a parent or caregiver.
May react to the absence of a parent or caregiver with increased crying, decreased responsiveness, and changes in eating or sleeping.
May keep looking or asking for a missing parent or caregiver and wait for him or her to return.
Are most affected by the sadness of surviving parent(s) and caregivers.
Preschool-age children (3 to 6 years)
Are curious about death and believe it is temporary or reversible.
May see death as something like sleeping. In other words, the person is dead but only in a limited way and may continue to breathe or eat after death.
Often feel guilty and believe that they are responsible for the death of a loved one, perhaps because they were "bad" or wished the person would "go away."
May think that they can make the person who died come back if they are good enough.
May worry about who will take care of them and about being left behind.
Are very affected by the sadness of surviving family members.
Cannot put their feelings into words and instead react to loss through behaviors such as irritability, aggression, physical symptoms, difficulty sleeping, or regression (such as bed-wetting or thumb-sucking).
School-age children (6 to 12 years)
Understand that death is final.
May think of death as a person or a spirit, like a ghost, angel, or a skeleton.
By age 10, understand that death happens to everyone and cannot be avoided.
Are often interested in the specific details of death and what happens to the body after death.
May experience a range of emotions including guilt, anger, shame, anxiety, sadness, and worry about their own death.
Struggle to talk about their feelings. Their feelings may come out through behaviors such as school avoidance, poor performance in school, aggression, physical symptoms, withdrawal from friends, and regression.
May worry about who will take care of them, and will likely experience feelings of insecurity, clinginess, and abandonment.
May worry that they are to blame for the death.
Teenagers (13 to 18 years)
Have an adult understanding of the concept of death but do not have the experiences, coping skills, or behavior of an adult.
May act out in anger at family members or show impulsive or reckless behaviors, such as substance use, fighting in school, and sexual promiscuity.
May experience a wide range of emotions but not know how to handle them or not feel comfortable talking about them.
May question their faith or their understanding of the world.
May not be receptive to support from adult family members because of their need to be independent and separate from parents.
May cope by spending more time with friends or by withdrawing from the family to be alone.
Keep in mind that there are no magic words nor just the "right" thing to say to a grieving child, teen or adult. Most importantly, listen, love and remind them they are safe and cared for by many people. Allow them space to express their feelings and create opportunities to share memories, funny stories or what they loved most about that person. Children & teens often need something to "do" so to speak, such as drawing pictures, creating a memory book, writing that person a letter or praying and sending them love & light every time they think about them. Actions allow children to move from overwhelming feelings to engaging their brains and bodies.
Some of my favorite books for discussing death with children include:
Dog Heaven by Cynthia Rylant
Life is Like the Wind by Shona Innes & Irisz Agocs
When Bad Things Happen: A Guide to Help Kids Cope by Ted O'Neal
For more in-depth information, please review this helpful booklet entitled After a Loved One Dies
(by New York Life).